Opioid Use and Storage Patterns by Patients after Hospital Discharge following Surgery

Opioid-based analgesic therapy represents a cornerstone of pain management after surgery. The recent rise in opioid sales and opioid overdoses suggests it is important to maximize the safety of opioid prescribing after surgery. Given that patients may live with other family members in the home, safe...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:PloS one Jg. 11; H. 1; S. e0147972
Hauptverfasser: Bartels, Karsten, Mayes, Lena M., Dingmann, Colleen, Bullard, Kenneth J., Hopfer, Christian J., Binswanger, Ingrid A.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 29.01.2016
Public Library of Science (PLoS)
Schlagworte:
Academic Medical Centers
Adult
Aged
Analgesia
Analgesics
Analgesics - therapeutic use
Analgesics, Opioid - therapeutic use
Anesthesiology
Cesarean section
Cesarean Section - adverse effects
Cohort Studies
Colorado
Demographic aspects
Discharge
Drug Overdose - prevention & control
Drug Storage - methods
Emergency medical care
Family
Female
Health care facilities
Hospitals
Humans
Male
Medicine and Health Sciences
Morbidity
Narcotic abuse
Narcotics
Opioids
Overdose
Pain
Pain Management
Pain perception
Pain, Postoperative - drug therapy
Pain, Postoperative - etiology
Patient Discharge
Patient Safety
Patients
Pills
Polls & surveys
Practice Patterns, Physicians' - statistics & numerical data
Pregnancy
Research and Analysis Methods
Risk factors
Safety
Statistical tests
Storage
Studies
Surgery
Surveys
Surveys and Questionnaires
Thoracic surgery
Thoracic Surgical Procedures - adverse effects
Thorax
Colorado
United States
New York
United States > US
ISSN:1932-6203, 1932-6203
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Opioid-based analgesic therapy represents a cornerstone of pain management after surgery. The recent rise in opioid sales and opioid overdoses suggests it is important to maximize the safety of opioid prescribing after surgery. Given that patients may live with other family members in the home, safe storage and appropriate disposal of excess opioids after hospital discharge are necessary to prevent unintended secondary exposures. Identifying characteristics of patients who are likely to be prescribed excess opioids after surgery may enable more targeted prescription practices and safety interventions. Our study aimed to elucidate patient-reported opioid use patterns and modes of home storage of opioids among patients discharged home after Cesarean section (C-section) and thoracic surgery. Specifically, we sought to identify characteristics of patients who reported using about half or more versus less of the opioids prescribed to them for use after hospital discharge. For this cohort study, we developed a survey on quality of analgesia following hospital discharge, amounts of opioids taken relative to the amount prescribed, reasons for not taking all prescribed medications, and storage and disposal methods for leftover opioids. Adult patients, who had C-section or thoracic surgery at a tertiary academic medical center, were given a web-based self-administered survey after discharge. Descriptive statistics (means and standard deviations, proportions) were used to describe the study sample and survey results. Comparisons between patients who reported taking about half or more versus less of the opioids prescribed to them for use after hospital discharge were made using unpaired t-tests, Mann-Whitney tests, and Chi-square tests as appropriate. The majority (53%) of respondents after C-section (N = 30) reported taking either no or very few (less than 5) prescribed opioid pills; 83% reported taking half or less; and 17% of women, reported taking all or nearly all (5 or fewer pills left over) of their opioid prescription. In a cohort of patients after thoracic surgery (n = 31) 45% reported taking either no or very few (5 or less) prescribed opioid pills; 71% reported taking half or less; and 29% of patients reported taking all or nearly all (5 or fewer pills left over) of their opioid prescription. In both cohorts, use of opioids while hospitalized was higher in the group reporting using about half or more of prescribed opioids after discharge. Leftover opioids were stored in an unlocked location in 77% and 73% of cases following C-section and thoracic surgery, respectively. Our findings from surveys in two distinct patient populations at a single academic medical center suggest that current opioid prescribing practices for pain management at hospital discharge following Cesarean section and thoracic surgery may not account for individual patients' analgesic requirements. Excess opioid pills are commonly stored in unsecured locations and represent a potential source for non-medical opioid use and associated morbidity and mortality in patients and their families. Research to develop goal-directed and patient-centered post-discharge opioid prescription practices and encourage opioid safety practices after surgery is needed.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: KB LMM IAB. Performed the experiments: KB CD KJB. Analyzed the data: KB CJH IAB. Contributed reagents/materials/analysis tools: LMM KJB CD KB. Wrote the paper: KB CJH IAB.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0147972